Provider Demographics
NPI:1063815025
Name:BLITZER, AMY CRAWFORD (NP-C, DNP, RN)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:CRAWFORD
Last Name:BLITZER
Suffix:
Gender:F
Credentials:NP-C, DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2209
Mailing Address - Country:US
Mailing Address - Phone:651-266-1255
Mailing Address - Fax:
Practice Address - Street 1:153 CESAR CHAVEZ ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-2226
Practice Address - Country:US
Practice Address - Phone:651-602-7500
Practice Address - Fax:651-602-7580
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA0914005363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health